Predicting who will respond to GvHD therapy
Bone marrow transplantation is a highly efficacious treatment for leukaemia but is often complicated by graft-versus-host disease (GvHD), which accounts for the main toxicity of the procedure. During the last few years we have developed a hugely successfully national programme to treat severe refractory cases of GvHD with Mesenchymal Stromal Cells (MSC). In order to maximise the effects of this treatment we need to better understand how MSC work. We have recently discovered that MSC injected into GvHD recipients are killed by host immune cells. The dying MSC are fundamental to produce the control of GvHD. For this reason, here we propose to fully characterise the host killer cells in GvHD patients. The data will provide information to select the patients who are more likely to respond to MSC. We will also learn which drugs may interfere with the killer cells and ultimately perfect MSC therapies.